A Study On Th2-related Immune Molecules In Umbilical Cord Blood And Maternal Blood Of Infants With Atopic Dermatitis Aged 0-6 Months

ObjectivesTo evaluate the the relationship between the level of Th2-related Immune molecule in umbilical cord blood and maternal blood with atopic dermatitis in infants aged 0-6months.To provide a new diagnosis and treatment idea for taking relevant preventive intervention measures,reducing the occurrence of AD and delaying the allergic process.MethodsThe healthy baby born in the Affiliated Hospital of Qingdao University was selected as the research objectives,and the prenatal questionnaire survey was conducted to record the general information of the baby and the family history of allergies.Infant umbilical cord blood and maternal prenatal blood were collected.The contents of TSLP,IL-4,IL-13,IL-31 and Ig E in umbilical cord blood and maternal blood were detected by enzyme-linked immunosorbent assay.The follow-up period was 6 months,to observe AD,and divide them into AD group and AD-free group.SPSS25 software was used for analysis.Results1.In the 68 infants,including 32 in AD group and 36 in AD-free group,the incidence rate was 47.06%.2.General situation: There was no significant difference in sex(χ2=0.148,P>0.05),birth weight(t=1.437,P>0.05)and maternal delivery age(t=-1.74,P>0.05)between the two groups,which was balanced and comparable.The proportion of painless delivery in AD group was significantly higher than non-AD group(χ2=6.915,P < 0.05).There was no statistical difference between the two groups in whether the mother used antibiotics before delivery(χ2=0.021,P > 0.05)and the birth season(χ2=0.889,P > 0.05).3.Family history of allergy: There were significant differences between the two groups in family history of allergy(χ2=13.099,P < 0.05),allergic history of mother(χ2=11.806,P < 0.05)and history of AD of mother(χ2=7.696,P < 0.05).There was no statistical difference between the two groups in mother had allergic rhinitis history or not(χ2=7.696,P > 0.05),the father had allergic rhinitis history or not(χ2=0.387,P > 0.05),the father had AD history or not(χ2=0.077,P > 0.05)and the father had allergic rhinitis history or not(χ2=0.001,P>0.05).4.Th2-related immune molecules in umbilical cord blood: The level of IL-13 in umbilical cord blood of AD group was significantly higher than that of non-AD group,and the difference was statistically significant(t=4.531,P < 0.05).The level of TSLP in umbilical cord blood was significantly higher than that of AD-free group,the difference was statistically significant(z=-2.236,P < 0.05).There was no significant difference in umbilical cord blood IL-4(z=-0.092,P>0.05),IL-31(z=-1.192,P>0.05)and Ig E(z=-0.185,P > 0.05)between the two groups.5.Th2-related immune molecules in maternal blood: The level of TSLP in maternal blood of AD group was significantly higher than that in non-AD group,and the difference was statistically significant(z=-2.703,P<0.05).The level of IL-13 in maternal blood of AD group was significantly higher than that of non-AD group,with statistical significance(t=4.660,P < 0.05).There was no significant difference in maternal blood IL-4(z=-1.751,> 0.05),IL-31(z=-0.098,P > 0.05)and Ig E(z=-1.499,P > 0.05)between the two groups.6.Multi-factor analysis of infant AD: The presence or absence of infant AD was taken as the dependent variable,and the results of univariate analysis with statistical differences were taken as the independent variables for binary Logistic regression analysis.The results showed that the higther level of IL-13 in umbilical cord blood(OR=1.022,95% CI: 1.006 ～ 1.038,P < 0.05),the higher level of IL-13 in maternal blood(OR=1.030,95% CI: 1.010 ～ 1.049,P < 0.05)and the family history of allergy(OR=10.133,95% CI: 1.64 ～ 62.61,P < 0.05)is the risk factor for infant AD.Whether the mother has a history of AD is not an independent factor affecting the baby’s AD(OR=14.242,95% CI: 0.992 ～ 6204.537,P > 0.05).7.The levels of umbilical cord blood IL-13 and maternal blood IL-13 have predictive value for 0-6 months old AD.Umbilical cord blood IL-13 AUC=0.792,95% CI: 0.683 ～0.900,with the sensitivity of 81.30 % and the specificity of 72.20%.Maternal blood IL-13 AUC= 0.788,95% CI: 0.531 ～ 0.813,with the sensitivity of 59.40 % and the specificity of 91.70%.8.Multi-factor analysis of umbilical cord blood IL-13 level:(1)The birth season was set as a dummy variable with reference to summer: umbilical cord blood IL-13 level(pg/m L)=17.451×umbilical cord blood IL-4 level +1.911×umbilical cord blood TSLP level +23.179×(painless delivery of mother = 1;Non-painless delivery of mother=0)+37.122×(winter = 1;summer =0).(2)The birth season is set with autumn as the reference: umbilical cord blood IL-13 level(pg/m L)=17.451×umbilical cord blood IL-4level +1.911×umbilical cord blood TSLP level +23.179×(mother painless delivery = 1;Non-painless delivery of mother =0)+27.334×(winter = 1;autumn =0).Conclusion1.The level of IL-13 in umbilical cord blood has a certain relationship with the occurrence of AD in infants from 0 to 6 months,and the increased level is a risk factor for AD.2.The level of IL-13 in maternal blood has a certain relationship with the occurrence of AD in infants from 0 to 6 months,and the increased level is a risk factor for AD.3.Family history of allergy is a risk factor for AD in infants aged 0-6 months.4.The level of IL-13 in umbilical cord blood has a certain relationship with the baby’s birth season,and it is higher in winter than in autumn or summer.5.The level of IL-13 in umbilical cord blood is higher in painless labor with ropivacaine and sufentanil.